• Objectives (Learning outcomes)
▪ Define vital rate
▪ Illustrate birth rates
Vital Rates ▪ Illustrate mortality rates
Dr/ abeer elsayed ▪ Illustrate morbidity rates
Lecturer of Public health ,Preventive
and Social medicine-BU
Definition Rates and ratios
It is the branch of medical statistics
concerned with registration and
Rate
presentation of vital events of The numerator is a
human life, component of the
denominator Ratio
e.g. births & fertility, deaths, health The numerator is not
included in the denominator
and diseases related subjects.
1- Birth Rates
1- Birth rates • Crud Birth rate.
• Fertility rates (indices):
2- Mortality rates – General Fertility rate (GFR).
3- Morbidity rates – Fecundity rate.
– Age – specific F.R.
– Total F.R.
– Gross Reproductive R.
– Net Reproductive R.
I- Crud Birth Rate (C.B.R.) Example
It is calculated as: Some vital statistics for specific population for the year 2015 are:
No. of live births of a certain locality and year x 1000 Total population: 12,000
Midyear population: 10,000
Mid-year population of the same locality & year Live births: 500
Calculate Crude birth rate .
answer II-Fertility rates :
1- General fertility rate (GFR)
Crude birth rate = It is calculated as:
No. of live births of a certain locality and year x 1000 No. of live births of a certain locality and year x 1000
Females in childbearing period in same locality & year
Mid-year population of the same locality & year
(4 –5 times B.R.)
=(500*1000)/10000=50 per 1000 -Advantage
More precise index than birth rate as female is child bearing consist ¼ - 1/5 the total
population.
-Drawbacks
• All females in child bearing period are included and not only the married ones.
• It doesn’t take into consideration difference in age distribution in population of different
Countries.
Example Answer
Some vital statistics for a specific population for the year 2011 are: General fertility rate (GFR)=
Total population: 10,000
Live births: 700 No. of live births of a certain locality and year x 1000
Females in childbearing period in same locality & year:3500
Females in childbearing period in same locality & year
=(700*1000)/3500=200 per 1000
Calculate General fertility rate (GFR)
2- Fecundity Rate 3- Age – Specific F.R.
It is calculated as: It is calculated as:
No. of live births of a certain locality and year x 1000 No. of live births born to mothers of a certain 5 years age group
in a given locality and year x1000
Married women in childbearing period in the same locality and year
Females in the same age group, locality and year
Advantage:
Better index than G.F.R as it considers the difference in age distribution
of females in population of different Countries.
4- Total Fertility rate 5- Gross- Reproduction Rate
▪ The gross reproduction rate (GRR) is the Average Number of Daughters a Woman
Would Potentially Have in The Course of Her Life;
Total F.R of any given age group = age-specific rate x 5.
• It is calculated by Multiplying the Total Fertility Rate by the
Percentage of Females Live Births to the Total Birth.
It is the "Expected Number" of Children a Woman Would • GRR = sum of (age-specific fertility rates) * proportion of female births
Potentially Have in The Course of Her Life
Drawback:
• it ignores the fact that some women will die before completing
their childbearing years
Significance of Gross- Reproduction Rate 6- Net Reproduction Rate
Replacement Level: ❖ Net reproduction rate, R0, is similar to the gross reproduction rate but takes into
account that some females will die before completing their childbearing years.
• A GRR of 1.0 indicates that, on average, each woman would produce
❖The formula for the net reproduction rate (R0) is:
exactly one daughter to replace herself, assuming no mortality.
R0 = Σ (lx * mx), where:
• A GRR greater than 1.0 suggests that the next generation of women
• lx: represents the probability of a female surviving to age x (survival rate).
would outnumber the current one, indicating potential population growth.
• mx: represents the age-specific fertility rate at age x (average number of
• A GRR less than 1.0 suggests that the next generation of women would
daughters born to a woman at age x).
be smaller than the current one, indicating potential population decline
Crude death rate
2- Death (mortality) statistics = General death rate
It is the total number of deaths per 1000 population of a certain
1- Crud death rate locality (or country).
2- Specific death rates It is calculated as:
A- Age specific death rate Total number of deaths of a certain locality
B- Sex specific mortality rate x1000
Mid – year population in the same locality
C- Mortality of disease
2- Specific Death Rates A- Age specific Death rates
It represents the number of deaths of a particular group of 1- Infant Mortality Rate (IMR)
population per 1000 individuals of the group. (Infant is the baby in the 1st year of life):
The group may be particular for age, sex, occupation and social or No. of deaths of babies (< 1y of life) in certain locality and year X 1000
other aspect.
No of live births of the same locality and year
Infancy period is classified a- Neonatal Mortality rate
into :
No. of deaths of infants during the 1st m. of life in certain locality & year X 1000
1. Novonatal period → infant in the 1st No. of live births of the same locality and year .
week of life.
2. Neonatal period → infant in the 1st
months of life.
3. Post-neonatal period → infant in the
next 11 months
0 Neonatal 1m. Post – neonatal 12m.
Infant
pre-school child Mortality (Child 1-4 Years Mortality
b- Post neonatal mortality Rate: =
rate )
No. of deaths from 1 month to 1 year of age in certain locality & year X 1000 No. of deaths of children aged 1-4 y in a certain locality & year X 1000
No. of live births of the same locality and year No. of children of the same age group in the same locality and year
Still Birth Rate
(Late foetal Mortality R.) Perinatal Mortality
No. of deaths occurs in the perinatal period (stillbirth+ early neonatal death) in
No. of deaths of foetus after 28th weeks of pregnancy certain locality & year X 1000
in certain locality & year X 1000 No. of live births + No. of still births in the same locality and year
No. of LIVE births+ No. of stillbirths of the same the perinatal period (the period around labour, from 28th week of pregnancies
to the end of 1st week after births.
locality and year
Perinatal M.R = Still birth R. + novonatal M.R .
Perinatal M.R is an index of maternal care and early neonatal care.
example
At benha city in 2015 some statstics were • Calculate
• No. of deaths from 1 month to 1 year of age= 700 • 1-neonatal mortality rate
• No. of live births =15000
• 2-Post neonatal mortality rate
• No. of still births = 500
• No. of deaths of infants during the 1st m. of life =1500 • 3-Still birth rate
• No. of deaths of infants during the 1st week of life =400 • 4- Perinatal mortality rate
• No. of deaths of children aged 1-4 y=900
• 5- pre-school child Mortality rate
• No. of children aged 1-4 y=12000
• 1-neonatal mortality rate= • 2-Post neonatal mortality rate =
No. of deaths of infants during the 1st m. of life in certain locality & No. of deaths from 1 month to 1 year of age in certain locality & year
year X 100 X 100
No. of live births of the same locality and year No. of live births of the same locality and year
=(1500*100)/15000=10% =(700*100)/15000=4.6%
•
• 3-Still birth rate = • 4-Perinatal mortality rate=
No. of deaths occurs in the perinatal period (stillbirth+ early neonatal death) in certain
No. of deaths of foetus after 28th weeks of pregnancy in certain locality locality & year X 100
& year X 100 No. of live births + No. of still births in the same locality and year
=(1400*100)/(500+15000)=9.03%
No. of LIVE births+ No. of stillbirths of the same locality and year
=(1000*100)/(500+15000)=6.4%
Sex specific mortality rate e.g.: (Maternal
Mortality Ratio; MMR)
• pre-school child Mortality rate =
No. of deaths of children aged 1-4 y in a certain locality & year X 100
No. of deaths of mothers due to causes related to pregnancy ,
No. of children of the same age group in the same locality and year labour & purperium in certain locality and yearx100.000
=(900*100)/12000=7.5% No. of live births in the same locality and year
Mortality of Diseases Example
Some vital statistics for the island of Summerton for the year 2015 are:
1- Case fatality rate:
Midyear population: 16,500
No of deaths due to Sepsis : 300
No. of deaths of a particular disease in certain locality & year Total (cumulative) cases of Sepsis:5,000
= x 100
No. of reported cases of the disease in the same locality & year Calculate Case fatality rate
Answer
1- Case fatality rate: 2- Mortality rate (cause specific mortality rate):
No. of deaths of a particular disease in certain locality & year No. of deaths of a particular disease in certain locality & year
x 100 = x 100
No. of reported cases of the disease in the same locality & year
population at risk
=(300*100)/5000=6 %
Example Answer
Some vital statistics for the island of Summerton for the year 2015 are: • The cause-specific fatality rate due to pneumonia =
Total population: 10,000
No. of deaths of a particular disease in certain locality & year *100
Midyear population: 16,500
Total deaths: 500 population at risk (mid year population)
Pneumonia cases: 13 =(200*100)/16500=1.2 %
Deaths due to pneumonia: 200
Calculate The cause-specific fatality rate due to pneumonia
3- Proportionate Death rate :
3- Morbidity statistics
It is the percent proportion of the number of deaths of a particular disease
to total deaths in certain locality & year.
1- Incidence rate
No. of deaths of a particular disease in certain locality & year
2- Prevalence rate
= x 100
total deaths in the same locality and year
So, the causes of death can be arranged by their magnitude, and leading causes (major
causes) of death can be found.
Incidence rate
Used for acute & chronic diseases Incidence of chronic diseases
Incidence rate of acute disease
No. of new cases of a particular disease reported during a given time x 100000
No. of reported (new)cases of a particular disease during a given time Population at risk
x100000
Population at risk
Example
• In 2003, about 500 new cases of acquired immunodeficiency syndrome (AIDS) Prevalence rate
were reported in the country X. The estimated mid-year population of the country in used for chronic diseases.
2003 was approximately 30,000. Calculate the incidence rate of AIDS in 2003.
No. of total cases of disease diagnosed by survey study during a defined
Incidence rate = No. of new cases of a particular disease reported during a given time x 1000
Population at risk
period of time X100000
= (500 ⁄ 30000) *1000= 16 new cases of AIDS per 1000 population population examined (at risk)during this period
Example Example
• Calculating Prevalence In a survey of 1000 women who gave birth Some vital statistics for the island of Summerton for the year 2015 are:
in a town X, at a given time, a total of 50 women had preterm labor.
Calculate the prevalence of preterm delivery in this group.
Midyear population: 16,500
New Sepsis cases: 300
No. of total cases of disease diagnosed by survey study during a defined period of time X 100 Total (cumulative) cases of Sepsis:5,000
Live births: 500
Prevalence=
population examined (at risk)during this period
Deaths due to heart disease: 57
Total deaths: 500
surveyed Prevalence = (50 ⁄ 1000 )× 100 = 5% Calculate prevalence and incidence of sepsis in the island of Summerton .
answer
Prevalence rate= Incidence rate of acute disease
No. of total cases of disease diagnosed by survey study during a defined No. of reported (new)cases of a particular disease during a given time
period of time X100 x100
population examined (at risk)during this period Population at risk
=(5000*100)/16500=30.3% =(300*100)/16500=1.8%
Example
In a population of 500,000 people, 18,000 have been diagnosed with • Prevelance =
diabetes. What is the diabetes prevalence rate per 100,000 people? No. of total cases of disease diagnosed by survey study during a defined
period of time X100
a-.18
b- 18,000 population examined
c-3,600 =(18000*100)/500000=3.6%
d-,036
Example
Attack rate • In an outbreak of gastroenteritis among people who ate meals at a hotel, 99 persons
ate raw salad, 30 of whom developed gastroenteritis. Calculate the attack rate of
used to detect incidence of acute diseases during outbreak or epidemic . gastroenteritis among persons who ate salad.
• Numerator = 30 persons who ate Salad and developed gastroenteritis Denominator =
No. of new cases of a particular acute disease reported during a given time 99 persons who ate salad Food
and place during epidemic or outbreak x 100 persons who ate Salad and developed gastroenteritis x 100
attack rate= persons who ate Salad food
Population at risk in certain time and place
attack rate = (30 ⁄ 99) × 100 = 0.303 × 100 = 30.3%
